Notification of Changes for Business Entity
General Information
Business Entity Name:	MARSH & MCLENNAN AGENCY LLC
Incorporation / Formation Date:
FEIN:	263237576
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	CLERMONT
Business Address
Address 1:	6279 TRI-RIDGE BLVD
Address 2:	STE 400
City:	LOVELAND
State:	OH
Zip:	45140
Phone:	513-338-5791
Fax:	228-701-2610
Business Web Site Address:
Business Email Address:	SHARON.FOGELMAN@MMA-MW.COM
Mailing Address
Address 1:	6279 TRI-RIDGE BLVD
Address 2:	STE 400
City:	LOVELAND
State:	OH
Zip:	45140
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:
New DBA/Trade Name:	NO	New DBA/Trade Name:
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
KIM SCHILLING	TECHNICAL ASSISTANT	3218158	YES		10/10/2016
STEPHEN T COULTER	TECHNICAL ASSISTANT	021-76-9980	YES		08/15/2016
STEPHEN MACGUIDWIN	CLIENT ADVISOR 2	384-08/0117	YES		08/15/2016
JENNIFER TURLEY	CLIENT ACCOUNT MANAGER 1	7482528	YES		11/02/2016
THERESA DALLAS	TECHNICAL ASSISTANT	1071634		YES	08/31/2016
BRAD FELBLINGER	PRODUCER	17197908		YES	04/30/2016
CHRIS MCATEE	FINANCE MANAGER IV	2343157		YES	10/31/2016
JENNIFER BROSSENNE	CLIENT ADVISOR 2	17664022		YES	09/30/2016
MARY KEENAN	CLIENT ADVISOR 2	67976		YES	09/30/2016
NICK ALLEN	CLIENT ADVISOR 2	8970784		YES	09/30/2016
RICHARD COSTELLO	PRODUCER	1025402		YES	09/21/2016
MARIA THOMAS	CLIENT ADVISOR 2	1104149		YES	10/19/2016

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	SHARON FOGELMAN
Title:	LICENSING COORDINATOR
Phone Number:	513-338-5791
Email Address:	SHARON.FOGELMAN@MMA-MW.COM